Summary: A case study showing how social determinants impacting health outcomes work in different zip codes and how these manifest in an urban neighborhood in southwest Atlanta.

Perhaps the single most sobering insight to arise from How Neighborhoods Make Us Sick is that life expectancy within different zip codes in the same city and metro area can widely vary–by a decade or more in some cases. There are a complex of factors in which these areas vary–social determinants–that profoundly affect the wellness and longevity of the residents in those neighborhoods.

The co-authors of this book, Veronica Squires and Breanna Lathrop, take academic discussion in the public health community and narrate how they personally experienced the realities of the factors that shape health outcomes. Their argument is that these social determinants go far beyond personal choices and “bootstrap” solutions. Much of this came through their personal realization that the presence and community involvement advocated in community development circles just weren’t enough. The first half of this book describes the journey of each of them in coming to this realization. Each chapter contains a sections describing the journey of each author around the impacts on health of poverty, employment (mostly in low wage jobs), food insecurity and nutrition, education and child development, housing availability, environmental issues (mold, lead), and homelessness, and health care access.

Breanna, a health care provider at the Good Samaritan Health Center in urban southwest Atlanta, came face to face with the reality that all her efforts at appropriate health interventions and care plans were being undone by these social determinants. Her patients were not getting better. Veronica and her husband moved into the neighborhood, lived out the commitments they had learned in community development, but little changed and both saw their own health deteriorate, despite having good educations and jobs. After nine years, they had to move out. Veronica writes:

“I left with severe anxiety, major depression, and recurrent panic attack episodes. Eric left with panic attacks too, along with high blood pressure and heart palpitations. We both left with psoriasis. Yet, even though I knew we were doing the right thing for the health of our family, I was grieving the loss of a vision and hope that community development alone could repair communities in a holistic, lasting, and scalable manner. As we pulled onto the highway, I turned around to look at the exit I had taken thousands of times to get home and thought, There has to be a better way to restore our communities.” (p. 89)

Part Two of the book begins with the co-authors writing about how they leaned into their faith in addressing these challenges. Their study of Jesus opened their eyes to his commitment to healing and overturning oppressive systems and structures that undermined the health and lives of the poor. They saw that to pursue this work was kingdom work.

Both describe the transformative practices they’ve had a part in implementing at the Good Samaritan Health Center, a donor-funded effort. Veronica is the chief administrative officer, and Breanna, the chief operating officer. They make some challenging statements about some of the mantras surrounding charitable giving in church circles, including volunteering as a substitute for giving, and “diversifying.” The health center itself offers a “full circle” of health care including medical and dental care, behavioral health care, health education, and healthy living practices.

Most strategic though are the partnerships they have developed to address housing issues, employment, health care for the homeless, nutrition (through neighborhood food initiatives and gardens), and a focus on early child development and education. They stress the importance of partnering with the community, listening to the community for its advice about what will be most helpful. They also address the issue of health access and insurance in the U.S. and the current decisions that exclude many from access to good health care, particularly preventive care. They argue that many of the interventions they have pursued save money, or even return money to communities, compared to the current alternatives that often result in repeat incarceration, emergency room usage, and hospitalizations.

It struck me that these women, and those they work with did not stop with the many reasons why things weren’t changing in southwest Atlanta, but looked for smart and biblical ways to pursue health equity, addressing the other factors that often undermined their patients’ health. They hit bottom, were honest about what that looked like for them, and then persisted.

The book also raises questions about whether we will recognize that equality is not enough when the playing field is not level. They advocate for health equity, recognizing that those at the bottom of the hill face a much harder task than those at the top to achieve the same outcome. Will a nation graced with so many resources rise to this kind of greatness? And to come back to the sobering insight with which I began, how will we respond to the fact that some of our near neighbors in the same city have a shorter life expectancy than we do? How is this not a pro-life issue? These were the questions I’m pondering after reading this book.

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Disclosure of Material Connection: I received this book free from the publisher. I was not required to write a positive review. The opinions I have expressed are my own.

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Summary: Explores a different metaphor for the church’s role in God’s mission, that of midwife to what God is birthing, and how this might change the ways we engage with our world.

One of the dominant metaphors for Christian cultural engagement today is that of battle, whether of spiritual warfare, a war to “reclaim” the culture, or retreat, because of perception that either we’ve been fighting the wrong war, or that we are seriously losing and need to re-group and re-build. A more sophisticated model is that of “changing” or “transforming” the world. Yet as James Davison Hunter points out in To Change The World, this has often been an exercise in starry-eyed naivete’ and a prescription for burnout when the world doesn’t easily or quickly change.

Michael Frost and Christiana Rice, two missional practitioners and theorists have come together in this book to suggest a different model, a different way of “joining” God in the mission. Their inspiration is drawn from Isaiah 42:14:

“For a long time I have held my peace, I have kept still and restrained myself; now I will cry out like a woman in labor, I will gasp and pant.”

Their contention is that it is God, through his work in Christ, who is birthing a new world and our role is akin to that of the midwife. They write:

“If God is groaning like a woman in labor, and if a new world is being born before our very eyes, being pushed forth through the cracks of our broken world, our job isn’t to hurry it along. Rather our job is to join God and partner with him in the delivery room and to stop imagining we can birth the new world with our own strategies and methodologies. Indeed, our attempts to usher in the new order in recent years haven’t produced the kid of restoration, redemption or reconciliation in this world that we believe God envisions” (p. 17).

Frost and Rice don’t stop with a new metaphor or a new paradigm but press this out in the practical work in which teams of missional people engage. They challenge us to forego our colonizing and rootless efforts at church planting that fail to listen to and attend to communities and develop wholistic ministry in partnership with its people. Instead they elaborate the metaphor of midwife, both in ancient Israel and contemporary practice.

Midwives neither give birth to the child for the mother nor “make it happen” according to a plan but attend women during their pregnancies. They make space for a birth to happen to remove all barriers to giving birth and welcoming new life. They study place, they notice signs, they look at physical space. They act flexibly and fearlessly to the changing circumstances of the birth process. They don’t spend lots of time arguing the importance of midwifing, but quietly live that narrative with the women they attend. Rice and Frost work out practical applications of these principles.

They also see that collaboration to effect change is a multi-level process: with individuals, interpersonally in small groups like families, in community, in institutions and in structures and systems. Much of this happens not just through “church” activities but through a transformed vision of our work that things about our work societally as well as individually.

Place and space is a big part of what they talk about, and often overlooked. They draw on the work of the Project for Public Spaces to identify seven principles for creating great spaces that missional communities in a space need to consider:

The neighborhood is the expert.

Craft a place, not a design.

Look for partners.

You can see a lot just by observing.

Have a vision.

Money is not the issue.

You are never finished.

The concluding two chapters concern the missional person. Not only do they attend to the changes God would birth, but they are changed themselves in the process. Often this comes through suffering. Change is disruptive and there will be push back. To love a place and its people and to persist in all this is hard and we will be changed through it.

The call of this book is not to quietism as opposed to human-centered activism, a kind of can-do, we can make it happen spirit. The midwife, is active, but in a different way, and this is what I most appreciate about the theme and approach of this book. It offers, to people who have begun to think they must make something happen to advance the mission of God, the insight that God has something God would give birth to in the world. Perhaps most striking is that this is a distinctively female metaphor–one of a woman attending to another giving birth, and God uses it of God’s self! Many of us who are fathers went through childbirth classes that taught us how we might attend and accompany our wives, perhaps in the presence of an obstetrician or midwife, in the incredible process of birth, one we could only support as our wives labored. Perhaps we might begin to draw upon that to understand and become skillful midwives in the birthing process of the new creation.

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Disclosure of Material Connection: I received this book free from the publisher. I was not required to write a positive review. The opinions I have expressed are my own.

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A park with walkways, a pavilion, playground, picnic areas, shaded with abundant trees. Around the perimeter on three sides some of the grandest homes in the city. On the fourth, an auditorium in neoclassical style, and in later years a senior facility. That was, and still in significant measure is, Wick Park. In the boom years of the first part of the twentieth century, this area was home to many of Youngstown’s most affluent citizens, sheltered away from the mills and factories that made their fortune. This Metro Monthlyarticle gives you a good idea of what some of the homes were like back then.

My first encounters with Wick Park were during a summer when I volunteered with a children’s ministry working in a more urban part of the North side. They offered a summer program and I helped volunteer, helping organize games and activities for the children at the park. I loved the combination of shelters, open spaces and an abundance of trees and shade that made this a delightful recreation spot for the children who were both a delight and challenge and left me beat at the end of every day.

Later, while I was in college, I took a physical conditioning course and one of our regular activities was to don our running clothes and do laps around Wick Park. Each lap, as I recall, was about a mile. When I started, I barely made it up Elm Street to the park and had to walk-run even one lap. Eventually I reached the point where I could do three or four laps easily, and the Park was a favorite place to run with a buddy or two whenever I needed a study break.

A view of Wick Park across Fifth Avenue from Park Vista (c) Robert C Trube, 2011

In recent years we would drive past Wick Park when we would visit my mom and dad during their last years when they lived in Park Vista, across the street. One of the nicest features of where they lived is that the front windows of their dining room looked out over the park.

The larger Wick Park district extended all the way over to Wick Avenue running north of Youngstown State. Wick Avenue at one time was Youngstown’s version of “millionaire’s row.” Apart from the restored Pollock Mansion and the Arms Museum of the Mahoning Valley Historical Society, most of these are gone, replaced by many vacant lots. Auto dealerships like State Chevrolet, where my wife bought her first car, are long gone. Going up Wick Avenue, one of the few businesses left is the Golden Dawn, where a number of us would go after volunteering at a free clinic next to campus in one of those mansions owned by First Christian Church at the time.

Many of the large homes were broken up into apartments, which eventually led to decline in their condition. Vacant homes that were eventually demolished are a reality here as elsewhere in Youngstown. But from what I’ve read and heard, there are some neighborhood organizations collaborating with others to renew the area. According to Metro Monthly efforts by the Wick Park Neighborhood Association and the Northside Citizens Coalition has led to everything from urban gardens, farmers markets, property divestment that has brought new residents in and rehabilitation of a number of the grand old houses. Efforts by Youngstown CityScape has led to improvements of the park including new signage, sidewalk repairs, accessible parking near the pavilion, a new playground, and security gates.

It seems that one thing every Rust Belt city is discovering is that you re-build neighborhood by neighborhood, business by business, institution by institution. It takes scrappiness, perseverance, and collaboration of city leaders, businesses, neighborhood leaders and residents–over a long period of time (think what it takes just to renovate one home!). The Wick Park Historic District is one of the jewels of Youngstown. I’m glad to hear there are people thinking, talking, and working hard to both recover past glories and build toward a new future in this area, and providing models for other neighborhoods in the city to follow.

I’d love to hear both about memories of the Wick Park area, and from those who are working to revitalize this area!

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Summary: Explores how the communal practice of reading in congregations fosters a learning community and shared social imagination the results in clearer congregational identity, sense of mission in one’s setting, and wider engagement with the environment, economics, and political order.

I came across the work of C. Christopher Smith a few years ago through an online version of The Englewood Review of Books. The online site has become one of my “go-to” places to learn about new releases and also great books available for discounts (usually in e-format). Smith is the editor of this enterprise which is tied in with the ministry of Englewood Christian Church in Indianapolis, an urban congregation on the east side of Indianapolis. In his previous book, Slow Church, which I reviewed a year ago, Smith offered a few more clues that books were not just a personal passion that his church indulges but that reading plays a role in its common life. In this book, Smith articulates a vision for reading that goes beyond personal or even common life to the common good of his congregation and wider community.

Fundamentally, he and his community have fostered the idea of becoming a learning organization, building on Peter Senge’s idea in The Fifth Discipline. Learning to read together, beginning with the scriptures both in preaching and the practice of lectio divina, and discussing other works together has helped his church understand its context as well as envision a different “social imaginary.” This is a key idea in the book, borrowed from the work of Charles Taylor. Social imaginaries are our mental images of how things are done in our social context, often not articulated nor evaluated. For example, it might be contended that we have accustomed ourselves to a very polarized political dialogue between two parties. And we may think we must choose one of the two alternatives, both individually, and communally as congregations or church bodies. A different social imaginary might envision a very different type of political engagement.

Smith contends that as we read, reflect, discuss and imagine together around the scriptures, and around books that may speak to our context, we can explore, and be confronted by different social imaginaries that change the way we think about who and why we are as a church, about when and where we are in our context, and how we think about our presence in our communities, in the physical environment we inhabit, in the economic order in which we participate, and the political order of our communities, states and nations.

I had two questions in mind as I was reading this book. One was, can you really hope for all this to happen from our reading of scripture and other good reading? The other was, how does he get his congregation to do this kind of reading together? The answer to the first question was simple. I found myself asking, “isn’t this in fact why I do Bob on Books in the first place?” I believe that not only the “book of all books” but also other good writing can change the way we see the world and our place in it and shape our actions in ways that seek the greater flourish of the people and the places we share life with. What Smith did here is give me better language for what, instinctively, I’ve sought to do on the blog, both in my own writing and my reviews of the writing of others.

Chapter 9 in the book helped answer the second question for me. As noted already, Smith and his community begin with the slow reading of scripture, and he believes that learning to attend to God’s word in these ways is both foundational and helpful in learning, and loving to attend to other words. Congregational leaders promote reading within various teams related to the particular work they are doing. Their goals are modest. Even one book read and discussed together in a year is good. They create spaces for conversations about reading in classes, book clubs and seminars. They make resources available including books related to a current sermon series, they develop a process for including reviews of books on websites and a process to curate those reviews. And they keep fostering the love of reading among the children of the congregation. I read this and was struck with the conclusion that even in a busy congregation (whose isn’t?) of people who don’t read much, this is doable.

Smith concludes the book with a couple of reading lists: an annotated one of books related to the chapters of the book, and a list organized by subjects of books that have been helpful to his church community. My impression was “meaty, but accessible” for both lists–plainly richer fare that the inspirational fiction and non-fiction that is the typical “Christian reading diet.”

It is refreshing when a book comes along that connects the dots and clarifies one’s understanding of the things one cares about. This was such a book, and in doing so, the book accomplished for me, or rather in me, what the author contends reading does for us. I concluded the book with fresh ideas about fostering learning community around books in the professional and church communities with which I connect. Hopefully, that will indeed lead to some “common goods.”

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Disclosure of Material Connection: I received this book free from the publisher. I was not required to write a positive review. The opinions I have expressed are my own.

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Did you know that you could have your own lending library in your front yard? Or the lobby of your church or business? This is the idea of the Little Free Library (LFL) organization. All this started in 2009 when Todd Bol of Hudson, Wisconsin built a little red school house as a tribute to his mother, a former school teacher, mounted it on a post in his front yard and filled it with books. People were invited to “take a book and leave a book.” Neighbors loved it, he made more of these for his friends, and a movement began. When Rick Brooks, a youth and community development educator at the University of Wisconsin with a background in social marketing, got involved, the movement took off. As of September 2015, there were 32,000 registered Little Free Libraries in all 50 states and in 70 countries. Evan Mark Zuckerberg has installed a Little Free Library at Facebook headquarters, in the form of a renovated phone booth.

I’d heard of these and even have come across a few in my travels. But what caught my attention was hearing of my son’s plans to place copies of his new book in some of the Little Free Libraries in our area. He even told me about finding one of these just blocks from our home, the only one, I discovered, in my zip code. It is pictured above. I suspect he will put one here and perhaps at the one nearby his home featured in a 2011 Dispatcharticle. These “Stewards” not only installed a Little Free Library, but even put a bench nearby so people could sit down and read. Since then they have sprung up all over our city, even in my neighborhood. Several elementary schools in a nearby school district secured a grant and installed Little Free Libraries in four of their schools.

The box owners (“Stewards”) may provide the initial collection of books for the Little Free Library, but the idea is that the collection quickly becomes a community collection. It all works on the honor system, where it is suggested that those who take a book, leave a book, perhaps not the one they took but one they have enjoyed. One of the benefits of this idea is creating neighborhood connectedness. Some Stewards have hosted block parties when they installed their Little Free Library. All of this feeds into the Little Free Library organization’s vision of “literacy friendly neighborhoods.” They even provide a toolkit for neighborhoods to organize around literacy.

The Little Free Library website is chock full of resources and stories and FAQs. You can order boxes, or make your own. It is recommended that you register your box, and when you do you will be provided with a box number, a charter sign and then you will be able to post your location on the site’s world map.

If your idea is to set up a library in a location you don’t own, you should clear this with owners and proper authorities. Even if you are putting this on your own property, it is probably a good idea to check with your neighborhood association, with local zoning ordinances, and utilities before you dig. The Little Free Library suggest that you might check with your home insurer about coverage and your attorney if you have questions about possible liabilities.

This seems like a great grassroots way community developers can promote literacy. Apparently 32,000 LFL Stewards agree. So does the grandest library of all, the Library of Congress. In October 2015, the Library of Congress honored the Little Free Library organization for promoting community literacy. Founder Todd Bol said, “For an organization that builds some of the smallest libraries around, it’s quite an honor to be recognized by the largest library in the world.”

The story of Little Free Libraries drives home the idea that fostering a literate society involves us all–children, parents, educators, neighbors, social organizations, community developers, and social entrepreneurs. What an amazing idea to come out of some scrap lumber!